Achieve Modifier 25 Success in Just 3 Easy Steps

Posted on 08. Mar, 2010 by suzanne.leder in Hot Coding Topics.

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Are you a 'gold star' ASC coder?

Understand ‘significant’ and ‘separate’ to earn a gold star.

Knowing when to report modifiers and choosing the best one for each situation can be an easy trip-up for coders. If you find yourself especially befuddled…

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EM Coding: Should I Select 99211 for Most Med Checks?

Posted on 06. Mar, 2010 by suzanne.leder in Coding Challenge.

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Insurers might want to see a clear explanation as to why the E/M was necessary.

Question: An established patient with a plan of care in place for her gastroesophageal reflux disease (GERD) reports to the gastroenterologist; two weeks ago, the

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E/M Coding: Use Current Diagnosis to Support E/M Visit

Posted on 05. Mar, 2010 by suzanne.leder in Coding Challenge.

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Don’t forget to include the code for the arthrocentesis.

Question: A new patient sees the orthopedist because of shoulder problems. The physician schedules an MRI and the patient returns the following week to discuss the findings. The physician had already

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Think You Understand the New Consult Rules? Find Out Fast

Posted on 04. Mar, 2010 by suzanne.leder in Hot Coding Topics.

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Check your 2010 consultation coding savvy.

Find out if you’re set to properly code your physician’s consultation services this year by tackling three problems and their solutions.

Check With Your MAC for Guidance

When…

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Medicare Physician Pay Cut Update

Posted on 03. Mar, 2010 by Editor in Provider News.

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On Tuesday evening, the Senate passed H.R. 4691, which freezes the Medicare conversion factor at current levels through March 31.

Because of this vote, you will not face the 21% pay cut until April 1, explains Part B Insider editor,…

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Ob-gyn Coding Challenge: EM End-Result Tells You What ICD Code To Go For

Posted on 03. Mar, 2010 by suzanne.leder in Coding Challenge.

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Check out these ICD-10 ob-gyn diagnosis coding equivalents.

Question: A patient presented for an initial OB visit. Another clinic confirmed her pregnancy, but she has never received prenatal care. The patient got her usual initial OB service (i.e. lab orders),

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CMS Tells MACs to Hold Claims For 10 Days

Posted on 02. Mar, 2010 by Editor in Provider News.

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The latest on the 21 percent Medicare pay cut.

If your practice leans heavily on Medicare for reimbursement, expect your cash flow to taper off a bit.

CMS has instructed the MACs to hold claims for the first ten business…

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Stay in the Game With the Correct Ligament Repair, Reconstruction Codes

Posted on 02. Mar, 2010 by suzanne.leder in Hot Coding Topics.

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Remember ligament repair abbreviations to simplify elbow ligament surgeries.

Baseball players are gearing up for the season, which means your orthopedist could see a sudden increase in elbow ligament injuries. If conservative therapies fail to help torn medial (841.1) or…

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Think You Understand the New Consult Rules? Find Out Fast

Posted on 28. Feb, 2010 by Editor in Coder's Cranium.

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Test your 2010 consultation coding understanding with these questions.

Consultation coding has every practice on edge this year. Ensure that you’ve got a handle on this complicated coding and billing situation by trying your hand at this question.

Question: When…

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Give Your Radiosurgery or Gamma Knife Surgery Coding a Check-Up

Posted on 28. Feb, 2010 by suzanne.leder in Hot Coding Topics.

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Improve your reimbursement chances by applying modifier 58 in this situation.

When your surgeon targets the brain or spine with stereotactic radiosurgery (also called gamma knife surgery) to treat multiple lesions over multiple sessions, you need to know two crucial…

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Ob-gyn Challenge: Take the Pressure Out of a 3D US Coding

Posted on 28. Feb, 2010 by suzanne.leder in Coding Challenge.

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No severe problems? You may have trouble with reimbursement.

Question: The ob-gyn performed and OB ultrasound (US) on a patient. Can I bill 76376 in addition to the ultrasound if the ob-gyn used 3D?

Montana Subscriber

Answer: Yes. You can…

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Counseling Must Dominate Exception Claims For Seamless Payment

Posted on 26. Feb, 2010 by suzanne.leder in Coding Challenge.

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Choose the service level using the documented history, exam, and MDM.

Question: A new patient with a chronic gastric ulcer meets the gastroenterologist for management of her condition. The gastroenterologist meets for 34 minutes with the patient, and performs an

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